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Justice News

Department of Justice
U.S. Attorney’s Office
Western District of Kentucky

FOR IMMEDIATE RELEASE
Monday, July 1, 2013

Operators Of University Of Louisville Hospital To Pay $2,833,408.60 To Settle False Medicare Billings

– University self-reported the over-billing for professional services

LOUISVILLE, Ky. – University Medical Center, doing business as University of Louisville Hospital, has voluntarily entered into a settlement agreement with the United States to pay $2,833,408.60 to settle allegations that it submitted or caused to be submitted false claims for payment to the Medicare program in violation of the Federal False Claims Act, announced David J. Hale, United States Attorney for the Western District of Kentucky, and the Office of Inspector General of the Department of Health and Human Services.

“Pursuing health care fraud is a priority of my Office, the Department of Justice, and the Department of Health and Human Services,” stated David J. Hale, United States Attorney for the Western District of Kentucky. “Those that do not follow the rules designed to safeguard our nation’s health care resources will be held to account.”

University of Louisville Hospital operates a separate fast track unit within the emergency department to address non-urgent care. This in-house immediate care center, FirstCare, is staffed by UMC-employed physician assistants (PAs) and nurse practitioners (NPs) under the direction of the Department of Emergency Medicine physicians – who in turn operate as University Emergency Medicine Associates.

According to the settlement agreement, from January 1, 2006 through December 31, 2010, the salaries and benefits paid to FirstCare PAs and NPs were claimed on UMC cost reports filed with Medicare between 2006-2010. At the same time, University Emergency Medicine Associate (UEMA) physicians generally treated the FirstCare PAs and NPs as their own employees including, to various degrees, billing and collecting from Medicare for their professional services.

In April 2011, counsel for UMC disclosed to the United States Attorney’s Office for the Western District of Kentucky that UMC may have violated federal law concerning the relationships it had with certain health care providers.

University Medical Center, Inc. is the 501(c) (3) organization which leases, operates and manages the University of Louisville Hospital and the James Graham Brown Cancer Center. UMC bills federal government health care programs, including Medicare, the TRICARE Program and Medicaid, for services it performs.

This settlement agreement is neither an admission of liability by UMC nor a concession by the United States that its claims are not well founded.

This matter was handled by Assistant U.S. Attorney Benjamin S. Schecter with assistance from the Department of Health and Human Services, Office of Counsel to the Inspector General.